Psychiatric disorders manifest themselves in different ways thus, these infirmities are classified into subtypes. Among the different mood disorders, there are various anxiety disorders and types of depression that can greatly reduce the quality of life for an individual. Ketamine can play a crucial role in the treatment of these different mood disorders. Thankfully, ketamine is a miraculous drug that has exceptional benefits in the following conditions:
Anxiety Disorders
Anxiety is a normal and natural response to stressful conditions. However, if this feeling of fear and insecurity persists for long periods of time, then it’s referred to as anxiety disorder. The prevalence of anxiety disorders is estimated to be between 10.3-19.1% in the US.
Anxiety is a natural process and is triggered by stressful events in life when one becomes fearful and insecure. However, experiencing high levels of anxiety on a daily basis is not a normal finding and indicates an underlying disease. If the symptoms of anxiety persist for more than 6 months then it must be referred to a mental health specialist and treated as generalized anxiety disorder.
Patients suffering from anxiety disorders find it difficult to get through the day. The abruptions in brain chemistry lead to destruction of interpersonal relationships and sleepless nights. Therefore, this disease affects not only the patient but their loved ones too.
Signs And Symptoms
Stressful conditions trigger the body's response towards the stimulus. The anxiety that develops as a result of some danger or stress activates the sympathetic nervous system of the body.
The sympathetic system is a part of your Central Nervous System (CNS) that prepares your body for a fight-or-flight situation. The activation of this system lasts monetarily in normal people, however, the feeling persists chronically in patients with anxiety disorders.
The most common symptoms of anxiety disorders include:
- Increased heartbeat (tachycardia)
- Heart palpitations
- Fearful thoughts and panic
- Shortness of breath
- Dry mouth
- Raised blood pressure
- Sweating
- Difficulty sleeping
Types Of Anxiety Disorders
There are different types of anxiety disorders identified by researchers:
Generalized Anxiety Disorder
The generalized disorder is a common finding and affects a number of people across the globe. It has a genetic predisposition and may also be triggered by stressful events such as childbirth, a study suggests.
Social Anxiety Disorder
This type of anxiety disorder affects around 13% of the US population. Social anxiety disorder makes patients susceptible to substance abuse. In this disorder, patients feel uncomfortable in social settings and constantly face the fear of being judged by others.
Panic Disorder
Panic disorder is characterized by sudden, intense bouts or episodes of fear. The patient experiences short of breath, with increased heartbeat and blood pressure.
Ketamine's Impact On Anxiety Disorders
Ketamine usage is directly linked to a reduction in anxiety disorders. According to research, ketamine alleviates symptoms in anxiety disorders.
The research investigated the effect of ketamine on both Generalized and social anxiety disorders by analyzing the brain's neuronal activity (via EEG). It was found that ketamine administration is effective for the management of anxiety disorders.
The rapid effect of ketamine in alleviating symptoms of anxiety disorders is so great that it is considered a therapeutic agent in their treatment.
A review declares that ketamine can be efficacious in the management of refractory anxiety disorders.
According to a 2020 study, ketamine rapidly provides relief of symptoms for psychiatric anxiety disorders. The study also found that the drug can help treat various phobias.
How Does Ketamine Work?
Glutamate abnormality is frequently seen in anxiety disorders. A raised glutamate to creatinine ratio was found in social anxiety patients. The rise in the ratio was directly proportional to the severity of psychiatric symptoms.
Ketamine is a potent antagonist of glutamate receptors in the brain (N-methyl-D-aspartate receptors). By binding to the receptor, ketamine decreases the activity of the glutamate receptor. Thus, alleviation of symptoms is seen. The pathophysiology of ketamine is the same for all types of mood disorders, therefore, it is not discussed further in the article.
If you suffer from anxiety, please call (310) 928-6863 to schedule a free consulation to see whether you’re a good candidate for Ketamine Infusions!
Bipolar Disorders
Bipolar mood disorders are characterized by cycling and swinging between extremes moods (i.e. extremely elevated and depressed moods). Patients suffering from bipolar disorder often cycle between a manic stage, chracterized by overwhelming happiness and excitment, and a depressed stage, characterized by sadness, gloom, and depression. The cycling between the two extreme moods affects the patient’s relationship with others and their activities of daily living.
Patients also show altered levels of energy, activity, and concentration. Modifications in thought and sleep patterns are also seen. Such patients variate between feelings of overwhelming happiness and utter sluggishness and hopelessness. Patients with bipolar disorder appear as maniacs.
Some bipolar disorder patients show mild symptoms and are termed hypomanics. The wavering moods do not interfere in daily life to a great extent.
Signs And Symptoms
The typical presentation of a bipolar patient is the manifestation of two extremes of moods. The mental level of the patient is at two "poles", thus, the term bipolar. When the patient is in “high pole” he feels the following:
- Immense confidence accompanied by feelings of hope and excitement
- Brisk transitions from very happy state to angry and relentless condition
- Hallucinations
- Delusions
- Decreased sleeping time (patients don't want to sleep)
- Loss of appetite
- Alcohol/drug abuse
When the patient is in the “low pole” the following symptoms are seen:
- Depression and sadness
- Hopelessness
Types Of Bipolar Disorder
There are three commonly encountered types of bipolar disorder.
Type 1
People suffering from type 1 bipolar disorder have extreme manic periods and need medical care. The hyper excited states may last for days or even weeks (at least a couple of weeks).
Type 2
In this particular type, there are erratic highs and lows in the patient's mood but the severity of the condition is lesser than type 1 cases.
Type 3: Cyclothymic Disorder
Like the other two, this type is also characterized by periods of depression and excitement. This type is not permanent and lasts for a couple of years in adults.
Ketamine For Bipolar Disorder
Ketamine infusions can aid in curing the undulations of the disorder. According to a study, ketamine is a potent NMDA antagonist that allows for rapid antidepressant effects in bipolar disorder patients.
A review published in the Journal of Psychiatric Practice found that ketamine infusion is an effective treatment modality in treating treatment resistant bipolar disorder with suicidal ideation. Another study found out that only a single dose of ketamine was sufficient in calming down the anxious type 1 bipolar disorder patients.
According to a 2020 review, ketamine infusions are completely safe to be used in the management of bipolar disorder and major depressive disorder. Analysis of rigorous testing revealed that ketamine is well tolerated by adult patients.
During the depressive mode, bipolar patients experience anhedonia. This is a state in which the patient doesn’t feel pleasure. The previously rewarding activities now have no effect on the patient. A study based on randomized controlled trials, suggests that a single ketamine infusion can improve symptoms of anhedonia in patients. The 36 participants of the study reported improvements in mood and reduction in anhedonia.
Therefore, ketamine not only works for the excited state but also provides improvements in the depressed state of bipolar disorder.
If you suffer from Bipolar Disorders, please call (310) 928-6863 to schedule a free consulation to see whether you’re a good candidate for Ketamine Infusions!
Major Depressive Disorders
In the medical world, clinical depression is known as Major depressive disorder (MDD). It is one of the many mood disorders that affect the individual’s quality of life. Patients experience issues with mood, appetite, sleep, and even day-to-day activities. In severe cases, physical functions may get compromised. There is a persistent feeling of sadness and loss of interest in worldly matters that follows the patient. This mental health disorder takes away the will to interact and carry out day-to-day activities. Some even lose the will to live.
Treating major depressive disorder is an uphill task for both the doctor and the patient. Despite the fact that disease affects almost 7% of US adults (as per an analysis of the year 2017), there is a relatively small number of people who seek medical treatment.
Signs And Symptoms
It is important for the symptoms to persist for more than 2 weeks to be classified as clinical depression. Sadness is a part of life and can last for a few days, however, clinical depression is a mental health disorder. Several clinicians follow the criteria provided by the Diagnostic and Statistical Manual of Mental Disorders (DSM) which includes:
- Mood/behavior changes observed by the patient
- Symptoms last for a couple of weeks or more
- Loss of interest or depressed feel is a must
Patients with MDD usually report being tired and restless. Feelings of guilt, worthlessness, and lack of self-confidence have also been reported with indivuduals suffering with MDD.
Ketamine For Major Depressive Disorder
Ketamine is a glutamatergic receptor antagonist that is efficacious in alleviating symptoms of clinical depression. In a randomized controlled trial, 20 patients suffering from major depressive disorder were given intranasal ketamine for 2 days. When compared with the placebo 8 patients showed remarkable improvements after 24 hours of ketamine administration. This indicated that ketamine is a safe, well-tolerated, and rapid-acting antidepressant even when given intranasally.
In another study, doctors discovered the anti-depressant role played by ketamine while they treated the pain with sub-anesthetic ketamine infusions. Ketamine showed promising and long-lasting results in the management of the major depressive disorder. Ketamine resets the hyperactive NMDA receptors to normal.
A meta-analysis confirms that ketamine is very efficacious in the management of depressive disorders (and bipolar disorder too). The patients showed no evident side effects.
Electroconvulsive therapy (ECT) is a common procedure followed in the management of depression and mental health issues. A comparative analysis of the efficacy of ECT and ketamine administration was done in 2013. The study highlighted the rapid antidepressant effect of ketamine. The NMDA receptor antagonist proved to have the same effect as ECT and that too quickly.
As per a review of different studies, it can safely be concluded that ketamine can be justly used for treating treatment-resistant depression. Another meta-analysis reveals that ketamine has mid-term as well as long-term positive effects in the treatment of major depressive disorders (MDD).
Ketamine administration has proven to be effective when it comes to alleviating depressive symptoms and enhancing cognition in depression patients. In a study of ketamine vs thiopental, ketamine was proven to be the more effective drug to be given with ECT.
Neurocognitive performance increases in major depressive disorder patients with ketamine infusions, a study suggests. Another study also suggests that ketamine can be used as a reliable treatment option in the management of MDD.
If you suffer from Major Depressive Disorder, please call (310) 928-6863 to schedule a free consulation to see whether you’re a good candidate for Ketamine Infusions!
Obsessive-Compulsive Disorder
OCD or Obsessive-compulsive disorder is a type of anxiety disorder where an individual is compelled to do something repetitively. This is a chronic disorder characterized by uncontrolled thoughts (obsessions) and behaviors (compulsions) to repeat the same tasks over and over again.
In this disorder, there are a myriad of recurring thoughts and obsessions that keep the patient anxious and wanting to respond to the ideas and thoughts with compulsive behavior. However, once the compulsive task is performed, there is a temporary feeling of relief. Some patients are found having an obsession of lining things up symmetrically while others are seen cleaning up stuff repeatedly.
Such patients are distressed at not being able to perform the tasks. In some cases, there is the self-realization that the thoughts and actions do not make sense but they can’t stop them.
Signs And Symptoms
The disorder interferes with daily life and presents as obsessions and compulsions.
Obsessions
Obsessions refer to repetitive, negative, and upsetting thoughts that the patient cannot control. The anxiety-inducing thoughts include:
- Aggressive thoughts (that are directed towards oneself)
- Most patients have a fear of contamination with germs
- Abnormal thoughts regarding sex or religion are also reported
Compulsions
Compulsions are the behaviors that a patient does repetitively as a result of obsessive thoughts. The most evident compulsions include:
- Constantly cleaning oneself (bathing, washing hands, etc.)
- Washing home, utensils, clothes, etc.
- Consistently putting things in a precise order
- Compulsive counting
Ketamine For Obsessive-Compulsive Disorder
This form of mood disorder can effectively be treated with ketamine. One of the advantages of ketamine infusions is the rapid alleviation of symptoms of OCD. According to a study, the use of NMDA receptor modulators is an efficacious step. The study found out that ketamine and rapastinel can be used in the treatment of OCD if the benefits outweigh the risks.
Serotonin reuptake inhibitors (SRIs) are the medicine of choice in the management of mental health problems (especially depression). Some cases do not seem to respond to the routine medications. For such cases, therapists can use ketamine because as per the latest study, repeated intravenous ketamine administration is advantageous in curing treatment-resistant OCD.
The effects of intranasal ketamine therapy on refractory Obsessive-compulsive disorder were analyzed. Intranasal ketamine, when given with Cognitive-behavioral therapy (CBT), leads to significant improvements in symptoms of OCD.
Ketamine offers superior results to the commonly used antidepressants (SRIs). A study claims that ketamine provided both immediate and delayed improvements in OCD patients. Therefore, ketamine can safely be used for immediate relief as well as a long-term treatment.
IV administration of ketamine is a beneficial step in treating different psychiatric disorders including major depressive disorders, bipolar disorders, and obsessive convulsive disorder, etc.
The latest 2020 study praised the quick relieving effect of ketamine when given for alleviating symptoms of Obsessive-compulsive disorder. This very drug is capable of initiating a quick response and therefore, is more effective than serotonin/norepinephrine reuptake inhibitors (SSRIs/SNRIs).
If you suffer from Obsessive-Compulsive Disorder, please call (310) 928-6863 to schedule a free consulation to see whether you’re a good candidate for Ketamine Infusions!
Postpartum Depression
Childbirth is a lifechanging process involving a lot different emotions for a mother to endure. Among many of the feelings that a woman experiences during childbirth, many feel an overwhelming amount of happiness and joy, however, others experience more complex emotions.
The hormonal changes associated with childbirth (or miscarriage) can trigger postpartum depression. The occurrence of this disease turns the joyous days into miserable nights. The mother is faced with issues like mood swings, excessive crying, and insomnia which interferes with her ability to nurture the newborn. There is a difference between postpartum depression and baby blues. Baby blues is a normal state found in new mothers and is found to resolve over time, whereas postpartum depression is a prolonged depressive state that requires medical attention.
Baby Blues
Most mothers experience a variety of moods which are collectively referred to as baby blues. This transient phase is filled with sad feelings and mood swings in the initial few days after delivering a baby.
Mothers experiencing baby blues report feelings of sadness, mood swings, and sleep disturbance. Baby blues only last for a couple weeks and do not need any medical attention. However, studies suggest that postpartum depression is a severe disorder that can last for 1 week to 4 months after the birth of the child.
Postpartum depression is a true form of depression that needs medications and/or therapy to be treated.
Signs And Symptoms
- Mood alterations and swings
- Irritability and anger
- Staying away from friends and family
- Sadness
- Appetite issues
- Sleeping issues
- Wanting to cry (and crying)
- Feeling overwhelmed
- Energy loss
Ketamine For Postpartum Depression
IV infusions of ketamine can help new mothers to get out of the gloom and despair. The drug with its glutamatergic antagonist response is capable of relieving symptoms such as loss of appetite and mood swings in mothers.
Some patients may suffer from a severe form of depression that is characterized by suicidal ideation. A study suggests that ketamine can be used as a prophylactic agent for postpartum depression. The randomized controlled study was carried out on 650+ women who gave birth by cesarean section. The administration of ketamine 10 minutes after birth proved to provide analgesia as well as significantly reduced baby blues and postpartum depression.
Another study found out that operative IV ketamine (0.25mh/kg) was able to reduce symptoms of postpartum depression for a week. As the cesarean section is a surgical procedure, many individuals also face depression associated with surgery. A study claims that ketamine should be used as a sub-anesthetic to prevent the development of post-operative depression.
Ketamine proved to be a safe drug for child-bearing mothers. Thus, it can be concluded that ketamine infusions should be employed prophylactically (as a sub-anesthetic) to prevent aggravation of baby blues and for the prevention of postpartum depression.
If you suffer from Postpartum Depression, please call (310) 928-6863 to schedule a free consulation to see whether you’re a good candidate for Ketamine Infusions!
Post-Traumatic Stress Disorder
Commonly known as PTSD, Post-traumatic stress disorder is the altered mental health condition that arises after exposure to trauma. Experiencing or witnessing any terrifying event can trigger post-traumatic stress disorder that has symptoms similar to other psychiatric disorders.
Patients suffering from this disorder are living in constant fear. Patients may start experiencing symptoms of PTSD within a month after the traumatic experience and these symptoms may last for many years.
Signs And Symptoms
The diagnosis is done on the basis of symptoms which are usually divided into 4 groups:
Avoidance
The patient avoids discussing the stressful traumatic event and goes on to avoid people and activities that remind him of the incident.
Bad Memories
Patients with PTSD complain of having flashbacks and nightmares of the past traumatic event. The intrusive memories put the patient in a condition similar to what they experienced in the first place.
Negative Thoughts
A change in thinking patterns are seen. PTSD patients become hopeless about the future and lose interest in activities they once enjoyed. This puts them far from their friends and family as they become emotionally numb.
Arousal Symptoms
Having passed through a trauma, these get frightened very easily. The inability to cope with constant fear makes them self-destructive and a lot of cases are seen putting their lives at stake. Patients have issues sleeping or waking and concentrating.
Ketamine For Post-Traumatic Stress Disorder
According to a well respected study published in the United States Army Institute of Surgical Research, ketamine was remarkably effective in preventing PTSD in burned patients. The prevalence of PTSD in burned soldiers receiving ketamine was 27% while in those that didn't get ketamine was 46%.
Another study claims that PTSD may be the result of synaptic disconnection following a trauma. Ketamine has emerged as a potent drug in the management of PTSD and therefore, it can be used for rapid relief of symptoms.
A 2019 review declared ketamine to be effective as a novel treatment modality for PTSD. Therefore, ketamine can be employed in the management of treatment-resistant PTSD (that doesn't respond to benzodiazepines and SSRIs).
A randomized controlled trial states that rapid reduction of symptoms is seen with IV infusions of ketamine.
Another study concludes that ketamine administration alleviates PTSD-like effects by altering the BDNF signaling pathways.
If you suffer from Post-Traumatic Stress Disorder, please call (310) 928-6863 to schedule a free consulation to see whether you’re a good candidate for Ketamine Infusions!
Summary
Ketamine can be used in a variety of mood disorders. The N-methyl-D-aspartate receptor antagonist effect of the drug is helpful in providing relief from anxiety disorders and major depressive disorders. Studies have shown that ketamine is a promising therapeutic agent in alleviating symptoms of Anxiety Disorder, Bipolar Disorders, Major Depressive Disorders (MDD), Obsessive-Compulsive Disorder (OCD), Postpartum Depression, and Post-Traumatic Stress Disorder (PTSD).
If you are interested in learning if Ketamine Infusions are right for you, please call (310) 928-6863 to schedule your free consultation with Dr. Ananth!
